Application value of white light endoscopic targeted biopsy in Tibetan gastric cancer risk population in Xizang region
10.3760/cma.j.cn321463-20240730-00350
- VernacularTitle:白光内镜下靶向活检在西藏地区藏族胃癌风险人群中的应用价值
- Author:
Pengfei SHAO
1
;
Wei LI
Author Information
1. 拉萨市人民医院消化内科，拉萨 850000
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Early gastric cancer;
White light endoscopy;
Targeted biopsy
- From:
Chinese Journal of Digestive Endoscopy
2024;41(12):1008-1011
- CountryChina
- Language:Chinese
-
Abstract:
To assess the application value of white light endoscopic targeted biopsy in Tibetan gastric cancer risk population in Xizang region, a prospective study was conducted and a total of 666 Tibetan subjects were recruited who were assessed as medium or high risk by a novel gastric cancer screening scoring system at the Department of Gastroenterology, Lhasa People's Hospital from June 2022 to December 2023. Patients were randomly divided into the experimental group (339 cases, underwent white light endoscopic targeted biopsy) and the control group (327 cases, underwent white light endoscopic traditional biopsy) using a random number table method. In the experimental group, 254 (74.9%) cases underwent white light endoscopic targeted mucosal biopsies after evaluation of the targeted mucosal biopsy strategy. The detection rates of gastric mucosal atrophy [31.1% (79/254) VS 19.9% (65/327), χ2=9.66, P=0.002] and intestinal metaplasia [22.4% (57/254) VS 15.9% (52/327), χ2=4.01, P=0.045] were significantly higher in the experimental group compared with the control group. The detection rates of early gastric cancer [7.5% (19/254) VS 4.0% (13/327), χ2=3.37, P=0.066] and advanced gastric cancer [0.0% (0/254) VS 2.1% (7/327), P=0.617] were not significantly different between the two groups. The number of biopsy sites [3 (2, 4) sites VS 5 (5, 5) sites, Z=10.50, P<0.001], the number of biopsy attempts [4 (3, 5) times VS 5 (5, 5) times, Z=8.43, P<0.001], and the examination costs [1 444.05 (1 211.20, 1 775.98) yuan VS 1 529.47 (1 351.73, 1 777.48) yuan, Z=1.96, P=0.001] were significantly lower in the experimental group than those in the control group. Among the 85 subjects in the experimental group who did not undergo biopsy, 9 cases [2.7% (9/339)] developed mucosal atrophy and 13 cases [3.8% (13/339)] developed intestinal metaplasia during a 12-month follow-up period, with no case of early or advanced gastric cancer. These findings suggest that for the Tibetan population at gastric cancer risk in the Tibet region, white light endoscopic targeted biopsy can effectively increase the detection rates of gastric mucosal atrophy and intestinal metaplasia while reduce biopsy rates, without significantly increasing the missed diagnosis rates of early and advanced gastric cancer. This approach can be promoted for clinical application.
